Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT

J Cardiovasc Comput Tomogr. 2015 Jul-Aug;9(4):354-61. doi: 10.1016/j.jcct.2015.04.007. Epub 2015 May 1.

Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT.

Osawa K1Miyoshi T2Morimitsu Y3Akagi T4Oe H5Nakagawa K1Takaya Y1Kijima Y1Sato S3Kanazawa S3Ito H3.

Comment: Cardiac CT is becoming an increasingly important tool for the assessment of cardiac anatomy and function, and has proven value in the anatomic assessment of secundum ASD. However, hemodynamic assessment, and pulmonary to systemic blood flow ratio with CT, has not been performed. The current study compared sizes of a secundum ASD as measured with cardiac CT (128-slice CT scanner, Siemens Medical Solutions), with transesophageal echocardiography, and the pulmonary to aortic blood flow ratio (Qp/Qs) with invasive catheterization. Fifty patients were included to undergo cardiac CT. Heart rate was lowered to <60 bpm using B-blockade, and contrast agent was given with an injection technique causing difference in contrast density between the right and left side of the heart. Sizes of the ASD as measured with CT were comparable to TEE (r=0.960; p<0.001); Qp/Qs as measured with CT was comparable to invasive catheterization (r=0.786; p<0.001). Radiation dose was relatively high, as the authors used retrospective gating methods. However, the results of the current study, and the rapid reduction in radiation exposure as CT technology develops, make cardiac CT an increasingly attractive imaging modality to anatomically and hemodynamically assess secundum ASD patients.